RESEARCH - Smoking, use of moist snuff, and risk of chronic inflammatory diseases

[Guest guest]

Am J Respir Crit Care Med. 2010 Jun 1;181(11):1217-22. Epub 2010 Mar 4.

Smoking, use of moist snuff, and risk of chronic inflammatory diseases.

Carlens C, Hergens MP, Grunewald J, Ekbom A, Eklund A, Höglund CO, Askling J.

Rheumatology Unit, Department of Medicine, Karolinska

Universitetssjukhuset Solna, SE-171 76 Stockholm, Sweden.

cecilia.carlens@...

Abstract

RATIONALE: Cigarette smoking is emerging as a strong risk factor in

the otherwise unknown etiology of chronic inflammatory diseases.

Whether the same applies also to smokeless tobacco remains unknown.

Nicotine is a powerful modifier of the inflammatory response. By

comparing risks associated with tobacco smoking and with smokeless

tobacco, the role of nicotine in the development of chronic

inflammation may be evaluated.

OBJECTIVES: To assess and compare the risks of rheumatoid arthritis

(RA), ulcerative colitis (UC), Crohn's disease (CD), sarcoidosis, and

multiple sclerosis (MS) associated with cigarette smoking and with the

use of Swedish moist snuff. METHODS: We performed a cohort study of

277,777 males within a cohort of Swedish construction workers who had

provided information about tobacco use in 1978-1993. Cross-linkage to

the nationwide Swedish Hospital Discharge Register provided

information about the occurrence of RA, UC, CD, sarcoidosis, and MS

through 2004. MEASUREMENTS AND

MAIN RESULTS: Age-adjusted relative risks (RRs) associated with

smoking and moist snuff, respectively, were estimated by

regression. Ever-smoking was associated with an increased risk for RA

(RR, 2.1; 95% confidence interval [CI], 1.7-2.5), CD (RR, 1.5; 95% CI,

1.2-1.8), MS (RR, 1.9; 95% CI, 1.4-2.6), and UC (RR, 1.3; 95% CI,

1.1-1.5, confined to ex-smokers), and a decreased risk of sarcoidosis

(RR, 0.5; 95% CI, 0.4-0.5). By contrast, ever-use of moist snuff,

adjusted for smoking, was not associated with RA (RR, 1.0; 95% CI,

0.9-1.2), UC (RR, 1.1; 95% CI, 0.9-1.2), CD (RR, 0.9; 95% CI,

0.8-1.1), sarcoidosis (RR, 1.1; 95% CI, 0.8-1.5), or MS (RR, 1.0; 95%

CI, 0.8-1.4).

CONCLUSIONS: Smokeless tobacco does not increase the risk of chronic

inflammatory diseases, suggesting that inhaled nonnicotinic components

of cigarette smoke are more important than nicotine itself in the

etiology of these diseases.

PMID: 20203245

http://www.ncbi.nlm.nih.gov/pubmed/20203245

Not an MD